Provider Demographics
NPI:1174770283
Name:FISHER, STEPHEN NEAL (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:NEAL
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 MUNHALL ROAD
Mailing Address - Street 2:APT #803
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2081
Mailing Address - Country:US
Mailing Address - Phone:412-606-1681
Mailing Address - Fax:412-422-1425
Practice Address - Street 1:5600 MUNHALL ROAD
Practice Address - Street 2:APT #803
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2081
Practice Address - Country:US
Practice Address - Phone:412-606-1681
Practice Address - Fax:412-422-1425
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH96352085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC31397Medicare UPIN
PAF1133436Medicare PIN